Planning, Management and Leadership for Health IT

1. Planning, Management and Leadership for Health IT Managing Change Lecture b — Leading Change This material (Comp 18 Unit 10) was developed by the University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0007. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org.

2. Managing Change Learning Objectives • Define change management • Discuss the importance of change management to the success of Healthcare IT system implementations • Describe the effects of introducing or changing information technology in a group or organization • Identify elements critical to successful management of change

3. It’s All About the People • Change management requires: • Understanding • Organization’s culture and structure • Human behavior • Leadership skills • Patience! Source: (McCarthy & Eastman, 2010)

4. Learning From Past Failures • Don’t repeat mistakes from past projects • Include your end-users and key stakeholders in the communication process • Include dissenters as part of the requirements, selection and implementation teams

5. Implementation Failure Step 1 • Leader’s Actions • Ask people to participate but don’t provide reasons for the changes • Decide on technology with no consultation • Don’t show up for practice session/training • Team Member Actions • Show up for training • Interpret absence of leader as message that team work is not important Source: (Fuller, 2010)

6. Implementation FailureStep 2 • Leader’s Actions • Discourage or remain neutral to team’s input • Reject new ideas from team members • Team Member Actions • Notice signals from leader • Re-evaluate behavior • Hold back from participation

7. Implementation FailureStep 3 • Leader’s Actions • Implementation data and users input finally analyzed and evaluated late in implementation • Team Member Actions • Declare project a failure

8. Repercussions of Implementation Failures Source: (Smelcer et al., 2009)

9. Implementation SuccessStep 1 Preparation • Leader • Explain selection process • Define roles and responsibilities • Encourage feedback • Team Members • Listen • Ask questions • Agree to participate Source: (Fuller, 2010)

10. Implementation SuccessStep 2 Training and Practice • Leader • Signal openness and feedback • Communicate reasons for change • Team Members • Participate fully • Ask questions; make suggestions • Try new approaches

11. Implementation SuccessStep 3 Review Data • Leader • Discuss with teams • Listen • Team Members • Collect data • Review data • Contribute to discussions • Outcome = Success! • New routines become established and accepted practice in the organization

12. Change Management Framework Source: (Canada Health Infoway, 2011)

13. Governance & Leadership • “The mechanisms used to guide, steer or regulate the course of a project” • Leadership responsibilities • Committee structure and roles • Roles of individual stakeholders • Change management decision making Source: (Canada Health Infoway, 2011)

14. Governance & Leadership 2 • Context for change management • Provides linkage between strategy, goals, and implementation activities Source: (Canada Health Infoway, 2011)

15. Stakeholder Engagement • Providing information about progress • Consulting and involving in decision • Collaborating for mutually agreeable outcome • Empowering for execution of decisions Source: (Canada Health Infoway, 2011)

16. Communication • Consistent • Repetitive • Open Source: (Canada Health Infoway, 2011)

17. Workflow Analysis & Integration • Understand current work processes • Allows process improvement • Decreases disruption • Allows employees to see value of new tools Source: (Canada Health Infoway, 2011)

18. Training • Plan to prepare users for upcoming change • Allow time for training • System training • Stress management Source: (Canada Health Infoway, 2011)

19. Monitoring & Evaluation (M&E) • Risk identification • Process improvement • Lessons learned • Celebration of success Source: (Canada Health Infoway, 2011)

20. Leadership: Ensuring Action • No one “must” do anything • Ensure that opinion leaders are part of the decision and implementation process • Use tools that are realistic; develop realistic goals Source: (Fuller, 2010)

21. Leadership: Ensuring Action 2 • Work to remove barriers to others’ success • Be sure you have effective internal channels of information exchange re: key issues • Apply power and influence to priorities • Measure and be accountable for results Source: (Fuller, 2010)

22. Informed Consent Photo by Sherrilynne Fuller, 2010

23. Managing Change Summary • Definitions of change management • Change management frameworks • Preparing and organization for change • Strategies for successful implementation

24. Acknowledgment • This presentation was adapted from Fuller S. Managing Change in Healthcare IT Implementations. Health Informatics Building Blocks. OER Africa. Licensed under Creative Commons Attribution-Share Alike 3.0 Unported. Available from: www.oerafrica.org

25. Managing Change References – Lecture b References Fuller S. Managing change in healthcare IT implementations. Health informatics building blocks. South Africa: OER Africa; 2010. Available from: www.oerafrica.org Canada Health Infoway. Managing change. Canada Health Infoway. 2011. Available from: www.infoway-inforoute.ca McCarthy C, Eastman D. Change management strategies for an effective EMR implementation. Chicago (IL): Healthcare Information and Management Systems Society; 2010. Available from: www.himss.org Smelcer JB, Miller-Jacobs H, Kantrovich L. Usability of electronic medical records. J Usability Studies [Internet]. 2009 Feb [cited 2012 Feb 15];4(2):[about 14 p.]. Available from: www.upassoc.org Image Slide 22: Sherrilynne Fuller. Personal collection.

26. Planning, Management and Leadership for Health ITManaging Change Lecture b This material was developed by the University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0007.